Published online by Cambridge University Press: 11 October 2022
The rate of structural malformations in monozygotic twins is higher than in dizygotic twins or singletons. The mechanical process of the embryo splitting may precipitate structural abnormalities leading to this higher incidence. Despite being genetically identical, monozygotic twins can be discordant for structural abnormality. Among the most common structural malformations in twin pregnancies are cardiac anomalies, neural tube and brain malformations, gastrointestinal and abdominal wall defects. Congenital heart disease is more prevalent in monochorionic twins, a proportion of which is caused in response to the abnormal physiology of twin-twin transfusion syndrome. First trimester ultrasound can identify those twin pregnancies at a higher risk of structural malformations and therefore lead to earlier detailed anatomy ultrasound and earlier prenatal diagnosis.
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